Performance of closed-loop resuscitation of haemorrhagic shock with fluid alone or in combination with norepinephrine: an experimental study.
Performance of closed-loop resuscitation of haemorrhagic shock with fluid alone or in combination with norepinephrine: an experimental study.
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DOI：
10.1186/s13613-018-0436-0
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发表时间：
2018-09-17
影响因子：
8.1
通讯作者：
Duranteau J
中科院分区：
文献类型：
--
作者：
Libert N;Chenegros G;Harrois A;Baudry N;Cordurie G;Benosman R;Vicaut E;Duranteau J
闭环复苏可以提高护理的个性化，减少工作量，并在隔离地区带来专业知识。我们已经开发了一种新的设备，以控制管理的流体或同时共同管理的流体和去甲肾上腺素使用动脉压。我们在出血性休克的啮齿动物模型中评估了我们的原型的性能。失血性休克后，大鼠被随机分为五个实验组：三个复苏的液体和液体和去甲肾上腺素的共同管理。在液体复苏组中，一组由医生复苏，两组根据两种不同的闭环算法复苏。在用液体和去甲肾上腺素复苏的组中，一组由医生复苏，另一组由闭环装置复苏。使用上升时间、在目标区域经过的时间和性能误差计算来评估复苏期间动脉压的精度。使用液体复苏的组具有相似的性能，并且在80-90 mmHg的目标区域中的时间与手动组相同[手动：76.8%（67.9-78.2），闭环：64.6%（45.7-72.9）和80.9%（59.1-85.3）]。采用闭环法复苏的大鼠在靶区的通过时间与手动法相似[闭环法：74.4%]（58.4-84.5）与手动：60.1%（46.1-72.4）]，但到达靶区的上升时间较短[160 s（106-187）vs. 434 s（254-1081）]。与仅用液体复苏的大鼠相比，用液体和去甲肾上腺素联合给药复苏的大鼠需要较少的液体，并且具有较少的血液稀释。单纯液体复苏组和液体加去甲肾上腺素复苏组之间的乳酸盐降低相似。 本研究广泛评估了几种算法的性能，用于出血性休克的闭环复苏，单独使用液体以及液体和去甲肾上腺素联合给药。测试的闭环算法的性能与医生指导的治疗相似，为护理人员节省了大量工作。动脉压闭环引导算法可以扩展到流体和去甲肾上腺素的组合施用。 本文的在线版本（10.1186/s13613-018-0436-0）包含补充材料，可供授权用户使用。
Closed-loop resuscitation can improve personalization of care, decrease workload and bring expert knowledge in isolated areas. We have developed a new device to control the administration of fluid or simultaneous co-administration of fluid and norepinephrine using arterial pressure. We evaluated the performance of our prototype in a rodent model of haemorrhagic shock. After haemorrhagic shock, rats were randomized to five experimental groups: three were resuscitated with fluid and two with co-administration of fluid and norepinephrine. Among groups resuscitated with fluid, one was resuscitated by a physician and two were resuscitated according to two different closed-loop algorithms. Among groups resuscitated with fluid and norepinephrine, one was resuscitated by a physician and the other one by the closed-loop device. The precision of arterial pressure during the resuscitation period was assessed using rising time, time passed in the target area and performance error calculations. Groups resuscitated with fluid had similar performances and passed as much time in the target area of 80–90 mmHg as the manual group [manual: 76.8% (67.9–78.2), closed-loop: 64.6% (45.7–72.9) and 80.9% (59.1–85.3)]. Rats resuscitated with fluid and norepinephrine using closed-loop passed similar time in target area than manual group [closed-loop: 74.4% (58.4–84.5) vs. manual: 60.1% (46.1–72.4)] but had shorter rising time to reach target area [160 s (106–187) vs. 434 s (254–1081)] than those resuscitated by a physician. Rats resuscitated with co-administration of fluid and norepinephrine required less fluid and had less hemodilution than rats resuscitated with fluid alone. Lactate decrease was similar between groups resuscitated with fluid alone and fluid with norepinephrine. This study assessed extensively the performances of several algorithms for closed-loop resuscitation of haemorrhagic shock with fluid alone and with co-administration of fluid and norepinephrine. The performance of the closed-loop algorithms tested was similar to physician-guided treatment with considerable saving of work for the caregiver. Arterial pressure closed-loop guided algorithms can be extended to combined administration of fluid and norepinephrine. The online version of this article (10.1186/s13613-018-0436-0) contains supplementary material, which is available to authorized users.
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影响因子：
8.8
作者：
Harrois, Anatole;Baudry, Nathalie;Duranteau, Jacques
通讯作者：
Duranteau, Jacques
DOI：
10.1007/bf01143186
发表时间：
1992-02-01
期刊：
JOURNAL OF PHARMACOKINETICS AND BIOPHARMACEUTICS
影响因子：
--
作者：
VARVEL, JR;DONOHO, DL;SHAFER, SL
通讯作者：
SHAFER, SL
影响因子：
2.2
作者：
Uemura K;Kawada T;Zheng C;Li M;Sugimachi M
通讯作者：
Sugimachi M
影响因子：
8.8
作者：
Hundeshagen G;Kramer GC;Ribeiro Marques N;Salter MG;Koutrouvelis AK;Li H;Solanki DR;Indrikovs A;Seeton R;Henkel SN;Kinsky MP
通讯作者：
Kinsky MP
影响因子：
5.8
作者：
Noguchi, Kimihiro;Gel, Yulia R.;Konietschke, Frank
通讯作者：
Konietschke, Frank